Priming with rocuronium accelerates the onset of neuromuscular blockade

Karl E. Griffith, Girish P. Joshi, Paul F. Whitman, Sandeep A. Garg

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Study Objective: To investigate the effects of priming rocuronium on the time course of neuromuscular blockade. Design: Prospective, controlled, randomized clinical study. Setting: University teaching hospital. Patients: 42 ASA physical status I and II patients undergoing peripheral surgery with general anesthesia. Interventions: Following a standardized propofol- fentanyl induction, patients in Group 1 (n = 21) received a priming dose of rocuronium 0.06 mg/kg followed two minutes later by an intubating dose of rocuronium 0.54 mg/kg. Patients in Group 2 (n = 21) received a saline placebo injection followed two minutes later by rocuronium 0.6 mg/kg. Anesthesia was maintained with isoflurane and nitrous oxide 60% in oxygen. Measurements and Main Results: Neuromuscular function was assessed at the wrist using mechanomyography with a single-twitch mode of stimulation at a frequency of 1 Hz until tracheal intubation and at 0.1 Hz thereafter. The times from injection of the intubating dose of rocuronium until 95% suppression of the twitch tension (onset time), recovery of twitch tension to 25% of control (clinical duration of action), and the time from 25% to 75% spontaneous recovery of twitch tension (recovery index) were recorded. The trachea was intubated at 95% depression of the twitch tension and the intubating conditions were graded using a 3-point scale. The onset times with priming rocuronium (34 ± 6 s) were significantly shorter (p < 0.01) than those without priming 59 ± 14 s). The intubation conditions were similar in the two groups; however, the intubating times with priming were significantly shorter. The clinical duration of action and the recovery index did not differ significantly between the two groups. Conclusions: Priming rocuronium decreased the onset times and thus, the intubating times without increasing the clinical duration of action or recovery index.

Original languageEnglish (US)
Pages (from-to)204-207
Number of pages4
JournalJournal of Clinical Anesthesia
Volume9
Issue number3
DOIs
StatePublished - May 1997

Fingerprint

Neuromuscular Blockade
Intubation
Injections
rocuronium
Isoflurane
Nitrous Oxide
Fentanyl
Propofol
Trachea
Wrist
Teaching Hospitals
General Anesthesia
Anesthesia
Placebos
Oxygen

Keywords

  • Mechanomyography
  • Neuromuscular monitoring
  • Neuromuscular muscular blocking drugs
  • Pharmacodynamics
  • Priming technique
  • Rocuronium

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Priming with rocuronium accelerates the onset of neuromuscular blockade. / Griffith, Karl E.; Joshi, Girish P.; Whitman, Paul F.; Garg, Sandeep A.

In: Journal of Clinical Anesthesia, Vol. 9, No. 3, 05.1997, p. 204-207.

Research output: Contribution to journalArticle

Griffith, Karl E. ; Joshi, Girish P. ; Whitman, Paul F. ; Garg, Sandeep A. / Priming with rocuronium accelerates the onset of neuromuscular blockade. In: Journal of Clinical Anesthesia. 1997 ; Vol. 9, No. 3. pp. 204-207.
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abstract = "Study Objective: To investigate the effects of priming rocuronium on the time course of neuromuscular blockade. Design: Prospective, controlled, randomized clinical study. Setting: University teaching hospital. Patients: 42 ASA physical status I and II patients undergoing peripheral surgery with general anesthesia. Interventions: Following a standardized propofol- fentanyl induction, patients in Group 1 (n = 21) received a priming dose of rocuronium 0.06 mg/kg followed two minutes later by an intubating dose of rocuronium 0.54 mg/kg. Patients in Group 2 (n = 21) received a saline placebo injection followed two minutes later by rocuronium 0.6 mg/kg. Anesthesia was maintained with isoflurane and nitrous oxide 60{\%} in oxygen. Measurements and Main Results: Neuromuscular function was assessed at the wrist using mechanomyography with a single-twitch mode of stimulation at a frequency of 1 Hz until tracheal intubation and at 0.1 Hz thereafter. The times from injection of the intubating dose of rocuronium until 95{\%} suppression of the twitch tension (onset time), recovery of twitch tension to 25{\%} of control (clinical duration of action), and the time from 25{\%} to 75{\%} spontaneous recovery of twitch tension (recovery index) were recorded. The trachea was intubated at 95{\%} depression of the twitch tension and the intubating conditions were graded using a 3-point scale. The onset times with priming rocuronium (34 ± 6 s) were significantly shorter (p < 0.01) than those without priming 59 ± 14 s). The intubation conditions were similar in the two groups; however, the intubating times with priming were significantly shorter. The clinical duration of action and the recovery index did not differ significantly between the two groups. Conclusions: Priming rocuronium decreased the onset times and thus, the intubating times without increasing the clinical duration of action or recovery index.",
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N2 - Study Objective: To investigate the effects of priming rocuronium on the time course of neuromuscular blockade. Design: Prospective, controlled, randomized clinical study. Setting: University teaching hospital. Patients: 42 ASA physical status I and II patients undergoing peripheral surgery with general anesthesia. Interventions: Following a standardized propofol- fentanyl induction, patients in Group 1 (n = 21) received a priming dose of rocuronium 0.06 mg/kg followed two minutes later by an intubating dose of rocuronium 0.54 mg/kg. Patients in Group 2 (n = 21) received a saline placebo injection followed two minutes later by rocuronium 0.6 mg/kg. Anesthesia was maintained with isoflurane and nitrous oxide 60% in oxygen. Measurements and Main Results: Neuromuscular function was assessed at the wrist using mechanomyography with a single-twitch mode of stimulation at a frequency of 1 Hz until tracheal intubation and at 0.1 Hz thereafter. The times from injection of the intubating dose of rocuronium until 95% suppression of the twitch tension (onset time), recovery of twitch tension to 25% of control (clinical duration of action), and the time from 25% to 75% spontaneous recovery of twitch tension (recovery index) were recorded. The trachea was intubated at 95% depression of the twitch tension and the intubating conditions were graded using a 3-point scale. The onset times with priming rocuronium (34 ± 6 s) were significantly shorter (p < 0.01) than those without priming 59 ± 14 s). The intubation conditions were similar in the two groups; however, the intubating times with priming were significantly shorter. The clinical duration of action and the recovery index did not differ significantly between the two groups. Conclusions: Priming rocuronium decreased the onset times and thus, the intubating times without increasing the clinical duration of action or recovery index.

AB - Study Objective: To investigate the effects of priming rocuronium on the time course of neuromuscular blockade. Design: Prospective, controlled, randomized clinical study. Setting: University teaching hospital. Patients: 42 ASA physical status I and II patients undergoing peripheral surgery with general anesthesia. Interventions: Following a standardized propofol- fentanyl induction, patients in Group 1 (n = 21) received a priming dose of rocuronium 0.06 mg/kg followed two minutes later by an intubating dose of rocuronium 0.54 mg/kg. Patients in Group 2 (n = 21) received a saline placebo injection followed two minutes later by rocuronium 0.6 mg/kg. Anesthesia was maintained with isoflurane and nitrous oxide 60% in oxygen. Measurements and Main Results: Neuromuscular function was assessed at the wrist using mechanomyography with a single-twitch mode of stimulation at a frequency of 1 Hz until tracheal intubation and at 0.1 Hz thereafter. The times from injection of the intubating dose of rocuronium until 95% suppression of the twitch tension (onset time), recovery of twitch tension to 25% of control (clinical duration of action), and the time from 25% to 75% spontaneous recovery of twitch tension (recovery index) were recorded. The trachea was intubated at 95% depression of the twitch tension and the intubating conditions were graded using a 3-point scale. The onset times with priming rocuronium (34 ± 6 s) were significantly shorter (p < 0.01) than those without priming 59 ± 14 s). The intubation conditions were similar in the two groups; however, the intubating times with priming were significantly shorter. The clinical duration of action and the recovery index did not differ significantly between the two groups. Conclusions: Priming rocuronium decreased the onset times and thus, the intubating times without increasing the clinical duration of action or recovery index.

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